<fieldset>
<legend>COI</legend>
	<table width="100%">
	<tbody>
		<tr>
			<td><strong>No Sertifikat</strong></td>
			<td><i id="tpl_cert_no"></i></td>
		</tr>
		<tr>
		<td width="20%"><strong>Referensi</strong></td>
		<td width="80%">
			<table>
				<tbody><tr>
					<td>Invoice</td>
					<td>No : <i id="tpl_ref_invoice_no"></i>
				</td>
					<td>Tanggal : <i id="tpl_ref_invoice_date"></i>
				</td>
				</tr>
<tr>
	<td>Packing List</td>
	<td>No : <i id="tpl_ref_packing_no"></i>
</td>
	<td>Tanggal : <i id="tpl_ref_packing_date"></i>
</td>
</tr>
<tr>
	<td>Bill of Lading/AWB</td>
	<td>No : <i id="tpl_ref_awb_no"></i>
</td>
	<td>Tanggal : <i id="tpl_ref_awb_date"></i>
</td>
</tr>
</tbody></table>
</td>
</tr>
<tr>
<td><strong>Barang yang diperiksa</strong></td>
<td><i id="tpl_inspected_goods"></i>
</td>
</tr>
<tr>
<td><strong>Tanggal</strong></td>
<td><i id="tpl_coi_date"></i>
</td>
</tr>
<tr>
<td><strong>Tertanda</strong></td>
<td><i id="tpl_coi_ttd"></i>
</td>
</tr>
</tbody></table>
</fieldset>

<br/>

<fieldset>
<legend>ROI</legend>
<table width="100%">
	<tbody><tr>
		<td width="20%"><strong>Report No</strong></td>
		<td width="80%"><i id="tpl_roi_no"/></i>
</td>
	</tr>
	<tr>
		<td><strong>Tanggal</strong></td>
		<td><i id="tpl_roi_date"></i>
</td>
	</tr>
	<tr bgcolor="#ccc">
		<td><strong>Referensi</strong></td>
		<td>
		<i id="tpl_roi_ref1"></i>
<br>
		<i id="tpl_roi_ref2"></i>
<br>
		<i id="tpl_roi_ref3"></i>
<br>
		</td>
	</tr>
	<tr bgcolor="#ccc">
		<td><strong>Result</strong></td>
		<td>
		<i id="tpl_roi_result1"></i>
		<i id="tpl_roi_result2"></i>
		<i id="tpl_roi_result3"></i>
		</td>
	</tr>
	<tr>
		<td><strong>Inspector</strong></td>
		<td><i id="tpl_roi_inspector"></i>
</td>
	</tr>
</tbody></table>
</fieldset>

<br/>
<div  class="form-field-box odd">
	<div id="io_no_display_as_box" class="form-display-as-box">
		No Inspection Order :
	</div>
	<div id="io_no_input_box" class="form-input-box">
		<i id="tpl_io_no"></i>				
	</div>
	<div class="clear"></div>
</div>
<div  class="form-field-box odd">
	<div id="ql_no_display_as_box" class="form-display-as-box">
		No Quotation Letter :
	</div>
	<div id="ql_no_input_box" class="form-input-box">
		<i id="tpl_ql_no"></i>				
	</div>
	<div class="clear"></div>
</div>
